KMD Bioscience Co., Ltd.
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2023-08-12 Hits(361)
Immune-mediated inflammatory diseases (IMIDs) are characterized by excessive and uncontrolled inflammation and thrombosis, both of which are responsible for organ damage, morbidity and death. Platelets have long been known for their role in primary haemostasis, but they are now also considered to be components of the immune system and to have a central role in the pathogenesis of IMIDs. In patients with IMIDs, platelets are activated by disease-specific factors, and their activation often reflects disease activity. Here we summarize the evidence showing that activated platelets have an active role in the pathogenesis and the progression of IMIDs. Activated platelets produce soluble factors and directly interact with immune cells, thereby promoting an inflammatory phenotype. Furthermore, platelets participate in tissue injury and promote abnormal tissue healing, leading to fibrosis. Targeting platelet activation and targeting the interaction of platelets with the immune system are novel and promising therapeutic strategies in IMIDs.
Immune-mediated inflammatory diseases (IMIDs) such as systemic lupus erythematosus (SLE), rheumatoid arthritis and psoriasis are highly prevalent, for example affecting 3–8% of the population in high-income countries, and they remain a major cause of morbidity and death worldwide despite therapeutic advances. IMIDs include autoimmune diseases characterized by autoantibodies and autoreactive T cells, such as SLE or systemic sclerosis, and inflammatory diseases such as psorias or inflammatory bowel disease. For most of these diseases, corticosteroids and nonspecific (antiproliferative) immunosuppressive drugs such as methotrexate or mycophenolate mofetil are the standard of care. These drugs reduce disease activity but have significant side effects, including myelosuppression and increased risk of infection. Furthermore, the risk of cardiovascular complications is increased significantly in individuals with IMIDs, as a result of both the disease itself and some of the drugs used to treat it (such as corticosteroids). For example, the risk of myocardial infarction is 50 times higher in young women with SLE than in age-matched and sex-matched controls. The increased risk of death from cardiovascular complications is shared across different IMIDs, which positions IMIDs as an independent risk factor for cardiovascular disease. A disease feature that has been identified as having a major contribution to the increased risk of thrombosis and cardiovascular disease is platelet activation. In the past 20 years, interest in understanding the immune roles of platelets has grown exponentially; in addition to their well-characterized role in primary haemostasis, platelets have been found to have important roles in immunity and inflammation.
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